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The directors of Sandglass Theater were approached five years ago by an organization that works to improve the lives of people who need home or residential care. The New York-based Paraprofessional Healthcare Institute wanted the southern Vermont company to help audiences better understand patients with Alzheimer’s or other cognitive illnesses.

“They were very interested in finding a theater company like ours to stage the actual stories that were created by circles of people with late-stage dementia,” said Eric Bass, co-artistic director of the Putney-based theater group. “Their interest was really to demonstrate how much creativity and how much of the creative faculty is still alive with people with late-stage dementia.”

The results of Sandglass Theater’s work, which brought Bass and two other Sandglass artists into Brattleboro-area residential-care facilities to talk with patients, can be seen in Burlington this weekend. “D-Generation: An Exaltation of Larks” presents those stories for the next three nights at FlynnSpace as part of the Flynn Center’s 2013-14 season.

Sandglass Theater employs puppets in its productions, which Bass said might help audiences better deal with the difficult topic of dementia. It’s not as “voyeuristic,” he said, to watch puppets wrangle with the fragments of their memories as it would be to watch a human actor.

“People with dementia make us uncomfortable. We are uncomfortable with everything that our society terms a disability,” Bass said by phone Friday from Bethlehem, Pa., where Sandglass Theater presented four performances of “D-Generation” last weekend. “In that way puppets help us look straight at someone with dementia with a freedom. We have fewer bridges to cross to get there.”

'Thoroughly in the moment'

A performance about dementia might sound daunting to viewers, but audiences have responded and ticket sales are going “very well,” according to the Flynn’s artistic director.

“We certainly haven’t presented it as a ‘Howdy Doody’ puppet show,” said Steve MacQueen, who books performances for the Flynn Center. “To me it seemed incredibly timely. We’re all grappling with the aging of America. It used to be a bit of a taboo subject. I think it’s much less so now because people are living longer. It’s much more prevalent.”

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Bass said Sandglass has heard from prospective patrons that the prospect of attending a performance that deals with dementia sounds intimidating.

“This show walks a very fine line, because dementia itself walks a very fine line between things that are genuinely interesting and funny and things that are dark and laden with terror. Our responsibility in the work on this piece was to stay on that line,” Bass said. “We take pains to balance that with a realistic look at this disease that is not at this time curable. We have found that people who have joined us for this show, joined us as audience members, have found something uplifting.

“We laugh in this show,” Bass said. “We don’t laugh at the residents, but we laugh with them, very much. We elicit the opportunities for that.”

With help from that laughter, Bass said, “D-Generation” is an entertaining performance and not a documentary or a lecture. “I would hope that people coming to spend a Friday or Saturday night in the theater with us would come away feeling good,” he said.

The modus operandi of Sandglass fits well with the way people with dementia tell stories, according to Bass, who said his 31-year-old company works in a nonlinear fashion. “We see the story as something that the audience collects through the course of the piece rather than something that unfolds chronologically,” he said. Storytelling from patients with dementia, Bass said, comes from “a more surprising place” than do stories from those who don’t have dementia.

“It’s less thought-through. It’s more wildly and freely associative. It’s thoroughly in the moment,” he said. “In people with late-stage dementia that barrier is down, that consciousness of, ‘Oh, I have to be clever now.’”

The role of art

Sandglass Theater worked with a Milwaukee-based organization called TimeSlips that began in 1996 with the idea that improvisational drama techniques could help people with Alzheimer’s and dementia. TimeSlips trained Bass and fellow Sandglass puppeteers Ines Zeller Bass and Kirk Murphy to be TimeSlips facilitators, and the trio spent 20 weeks working with patients with dementia in a pair of Brattleboro-area residential-care sites.

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“Our feeling was that we wouldn’t be able to create a piece just with the stories (TimeSlips) were giving us,” Bass said. “We needed to experience the way that the stories were collected. We needed to experience the people that were part of this story-making process. We needed to have a whole experience so we could have some sort of artistic reflection on what this was about.”

In a promotional video from Sandglass, one of the puppets in the midst of a discussion randomly shouts out, “Ahh, there’s a devil in the clouds!” The same woman is then shown, with help from the three puppeteers, dancing gracefully as if experiencing the freedom of creativity deep within those with dementia.

The director of recreation at one of the residential-care facilities Sandglass worked in called the project “a wonderful experience” for patients and staff.

“Our population is elderly and in some ways incapacitated and they have a hard time expressing themselves,” said Penny Carnevale of Pine Heights at the Brattleboro Center for Nursing and Rehabilitation. “(Sandglass) were so good at making sure they felt at ease and making sure they could say anything they wanted. They could say the craziest things and Eric and the troupe would validate anything they said and make it fit into the story.”

Carnevale believes the storytelling exercise had a long-term positive effect on many of the residents. “I think they felt they didn’t have anything to fear,” she said. “There was a lot of laughter, which is always really good.”

MacQueen, the Flynn Center’s artistic director, said the method Sandglass Theater used is an improvement over the old days when people tried “badgering” memories out of those with dementia. “Instead of harping on memory and asking questions that people don’t have the answers to, you let them tell the story,” MacQueen said.

Dr. William Pendlebury, director of the Memory Center at Fletcher Allen Health Care in Burlington, sees the value in an artistic project like what Sandglass Theater is doing.

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“We talk about things we can do for people with Alzheimer’s and dementia that have nothing to do with medication,” said Pendlebury, a professor in neurology and pathology at the University of Vermont College of Medicine and director of UVM’s Center on Aging. “Intellectual stimulation,” Pendlebury said, is one of those key therapies outside of medication, and storytelling is a good exercise for the brain that would help reduce the progression of a cognitive illness.

Bass said it’s important for people to talk about dementia. “We live in an age now where people are living longer. Dementia is so much more a part of our culture than we ever knew it was before,” he said. “There has to be some way of improving everyone’s relationship with this, because it’s hard to imagine anyone gets through life without knowing someone who is affected by this.

“Science will tell you its role in trying to help us with that, but art has to play its role, and the role of art is not to find a cure,” Bass said. “The role of art is to help improve the actual quality of life through our relationship to this part of our culture and society.”